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Actinomycosis as a Rare Local Manifestation of Severe Periodontitis


Kaldas, Moody; Barghorn, André; Schmidlin, Patrick R (2020). Actinomycosis as a Rare Local Manifestation of Severe Periodontitis. Case Reports in Dentistry, 2020:5961452.

Abstract

Actinomycosis is a chronic suppurative infection primarily caused by anaerobic gram-positive filamentous bacteria, primarily of the genus Actinomyces. Oral-cervicofacial actinomycosis is the localization found most often, presenting as a soft tissue swelling, an abscess, a mass lesion, or sometimes an ulcerative lesion. Periodontitis-like lesions, however, are rare findings. This report describes the case of a 41-year-old healthy female patient (nonsmoker), who was referred to the clinic with dull and throbbing pain in the second quadrant. Tooth 25 showed increased mobility and probing pocket depths up to 10 mm, with profuse bleeding upon probing. Radiographically, considerable interproximal horizontal bone loss was found, and the diagnosis of periodontitis stage 3, grade C was made. The situation was initially stabilized with adhesive splinting and local anti-infective therapy. Two weeks later, the bone defect was treated with guided tissue regeneration (GTR) using a xenogenic filler material (BioOss Collagen) and a resorbable membrane (Bio-Gide). Due to a suspicious appearance of the excised granulation tissue, the collected fragments were sent for histopathological evaluation. This evaluation revealed a chronic granulomatous inflammation with the presence of filamentous bacterial colonies, consistent with Actinomyces. The patient was successfully treated. While there are only few reports in the literature, actinomycotic lesions represent a rare but possible finding in cases with localized periodontal destruction. In conclusion, systematic biopsy of the infrabony tissue in localized periodontal lesions may help to provide a more accurate counting of Actinomyces-associated lesions, thereby improving diagnosis, therapy, and prevention.

Abstract

Actinomycosis is a chronic suppurative infection primarily caused by anaerobic gram-positive filamentous bacteria, primarily of the genus Actinomyces. Oral-cervicofacial actinomycosis is the localization found most often, presenting as a soft tissue swelling, an abscess, a mass lesion, or sometimes an ulcerative lesion. Periodontitis-like lesions, however, are rare findings. This report describes the case of a 41-year-old healthy female patient (nonsmoker), who was referred to the clinic with dull and throbbing pain in the second quadrant. Tooth 25 showed increased mobility and probing pocket depths up to 10 mm, with profuse bleeding upon probing. Radiographically, considerable interproximal horizontal bone loss was found, and the diagnosis of periodontitis stage 3, grade C was made. The situation was initially stabilized with adhesive splinting and local anti-infective therapy. Two weeks later, the bone defect was treated with guided tissue regeneration (GTR) using a xenogenic filler material (BioOss Collagen) and a resorbable membrane (Bio-Gide). Due to a suspicious appearance of the excised granulation tissue, the collected fragments were sent for histopathological evaluation. This evaluation revealed a chronic granulomatous inflammation with the presence of filamentous bacterial colonies, consistent with Actinomyces. The patient was successfully treated. While there are only few reports in the literature, actinomycotic lesions represent a rare but possible finding in cases with localized periodontal destruction. In conclusion, systematic biopsy of the infrabony tissue in localized periodontal lesions may help to provide a more accurate counting of Actinomyces-associated lesions, thereby improving diagnosis, therapy, and prevention.

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Item Type:Journal Article, not_refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Conservative and Preventive Dentistry
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > General Dentistry
Language:English
Date:February 2020
Deposited On:05 Jan 2021 18:28
Last Modified:24 Apr 2024 01:47
Publisher:Hindawi Publishing Corporation
ISSN:2090-6455
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1155/2020/5961452
PubMed ID:32089900
  • Content: Published Version
  • Language: English
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)